Aortic Geometric Alteration Associated With Acute Type B Aortic Dissection: Angulation, Tortuosity, and Arch Type.
Aortic Geometric Alteration Associated With Acute Type B Aortic Dissection: Angulation, Tortuosity, and Arch Type.
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与急性 B 型主动脉夹层相关的主动脉几何改变：成角、弯曲和弓型
DOI：
10.3389/fphys.2021.708651
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发表时间：
2021
影响因子：
4
通讯作者：
Shu C
中科院分区：
文献类型：
--
作者：
Sun L;Li J;Wang L;Li Q;He H;Li X;Li M;Wang T;Zhao C;Zhang X;Shu C
背景：急性B型主动脉夹层是一种非常严重的主动脉病变。主动脉几何参数可能是与急性B型主动脉夹层（aTBAD）发生相关的有用变量。本研究的目的是描述主动脉几何参数的变化，并分析与aTBAD相关的特定几何因素。方法：采用倾向评分匹配法控制混杂因素。通过3mensio软件（版本10.0，马斯特里赫特，荷兰）创建的三维计算机断层扫描成像，对aTBAD组和对照组的主动脉直径、长度、成角、迂曲度和主动脉弓类型进行回顾性分析。测量降主动脉真腔和假腔的几何参数，以估计主动脉夹层的严重程度。采用多变量Logistic回归模型分析与aTBAD发生相关的显著性和特异性因素。使用受试者工作特征曲线下面积（AUC）估计模型的性能。结果：经倾向评分匹配后，筛选出168对匹配的患者。aTBAD组升主动脉和主动脉弓内径明显扩张，升主动脉和主动脉总长明显延长（P < 0.001）。aTBAD组升主动脉和主动脉弓的角度较对照组明显变窄（P = 0.01，P < 0.001）。aTBAD组主动脉弓和主动脉总迂曲度显著高于对照组（P = 0.001，P < 0.001）。aTBAD组的III型牙弓患者多于对照组（67.9% vs. 22.6%）。真腔成角较假腔明显（P < 0.01）。真腔迂曲度明显低于假腔（P < 0.001）。多变量模型确定主动脉弓成角、迂曲度和III型主动脉弓是与aTBAD发生相关的独立和特定几何因素。多变量模型1、2、3的AUC分别为0.945、0.953和0.96。结论：除升主动脉延长和主动脉弓扩张外，主动脉弓和III型主动脉弓的更尖锐的成角和更高的迂曲度是与aTBAD相关的几何因素。真腔和假腔的角度和弯曲度对aTBAD的治疗和预后可能具有重要的临床意义。
Background: Acute type B aortic dissection is a highly serious aortic pathology. Aortic geometric parameters may be useful variables related to the occurrence of acute type B aortic dissection (aTBAD). The aim of the study is to delineate the alteration in aortic geometric parameters and analyze the specific geometric factors associated with aTBAD. Methods: The propensity score matching method was applied to control confounding factors. The aortic diameter, length, angulation, tortuosity, and type of aortic arch of the aTBAD and control group were retrospectively analyzed via three-dimensional computed tomography imaging created by the 3mensio software (version 10.0, Maastricht, The Netherlands). The geometric variables of true lumen and false lumen in the descending aorta were measured to estimate the severity of aortic dissection. Multivariable logistic regression models were used to investigate the significant and specific factors associated with aTBAD occurrence. The area under the receiver operating characteristic curve (AUC) was used to estimate the performance of the model. Results: After propensity score matching, 168 matched pairs of patients were selected. The ascending aorta and aortic arch diameters were dilated, and the ascending aorta and total aorta lengths were elongated in aTBAD group significantly (P < 0.001). The ascending aorta and aortic arch angulations in the aTBAD group were sharper than those of the controls (P = 0.01, P < 0.001, respectively). The aortic arch and total aorta tortuosities were significantly higher in the aTBAD group (P = 0.001, P < 0.001, respectively). There were more type III arch patients in the aTBAD group than the controls (67.9 vs. 22.6%). The true lumen angulation was sharper than that in the false lumen (P < 0.01). The true lumen tortuosity was significantly lower than that in the false lumen (P < 0.001). The multivariable models identified that aortic arch angulation, tortuosity, and type III arch were independent and specific geometric factors associated with aTBAD occurrence. The AUC of the multivariable models 1, 2, 3 were 0.945, 0.953, and 0.96, respectively. Conclusions: The sharper angulation and higher tortuosity of aortic arch and type III arch were the geometric factors associated with aTBAD in addition to the ascending aorta elongation and aortic arch dilation. The angulation and tortuosity of the true and false lumens may carry significant clinical implications for the treatment and prognosis of aTBAD.
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DOI：
10.1016/j.ejvs.2017.12.019
发表时间：
2018-04-01
影响因子：
5.7
作者：
Marrocco-Trischitta, Massimiliano M.;van Bakel, Theodorus M.;Trimarchi, Santi
通讯作者：
Trimarchi, Santi
影响因子：
3.4
作者：
Krueger, Tobias;Forkavets, Oksana;Schlensak, Christian
通讯作者：
Schlensak, Christian
影响因子：
37.8
作者：
Evangelista, Arturo;Isselbacher, Eric M.;Eagle, Kim A.
通讯作者：
Eagle, Kim A.
影响因子：
3.4
作者：
Krueger, Tobias;Grigoraviciute, Akvile;Schlensak, Christian
通讯作者：
Schlensak, Christian
影响因子：
--
作者：
Gode, Safa;Akinci, Okan;Erentug, Vedat
通讯作者：
Erentug, Vedat